Surgical appliance

ABSTRACT

An appliance for attachment to a surgical table is disclosed as a pivoted arch member for adjustable restraight of a patient&#39;&#39;s lower leg while it is bent to facilitate access to the region of the knee for surgical operations.

United States Patent Burris et al.

[ 1 SURGICAL APPLIANCE [76] Inventors: Lenard A. Burris; Theodore L.

Burris, both of 15310 Ashworth Ave. North, Seattle Wash, 98133 [221Filed: Feb. 4, 1974 [21] Appl No.: 439,001

[52] U.S. Cl. 269/328; 5/327 R [511 Int. Cl l. A61g l3/00 [58] Field ofSearch 269/328; l28/l33, [34; 5/327 R, 92

[56ml References Cited UNITED STATES PATENTS l4529l5 4/1923 Kennedy 7.5/327 R 1 51 Apr. 29, 1975 1.516.795 11/1924 Schwarting 269/328 FOREIGNPATENTS OR APPLICATIONS 1.377.482 9/1964 France 5/327 R PrirmlrE.\'uminer-R0y Lake Assistant E.ruminerNeil Abrams 1 1 ABSTRACT Anappliance for attachment to a surgical table is dis closed as a pivotedarch member for adjustable restraight of a patients lower leg while itis bent to facilitate access to the region of the knee for surgicaloperations 6 Claims, 4 Drawing Figures 1 SURGICAL APPLIANCE SUMMARY OFTHE INVENTION BACKGROUND During knee surgery considerable difficulty isen countered in presenting and maintaining a patients knee in a desiredimmobile, bent condition giving ready access for the surgeon. A commonpractice has been to assign an assitant or operating room technician tophysically grasp and place his body upon the patient's foot and lowerleg and remain there throughout. This is very fatiguing, crowds thesurgical arena, and does not always insure against unwanted changes inthe bent condition of the knee during the often protracted periods ofsurgery. An effort at providing mechanical restraint has involvedsecuring the bent leg in upright position by elastic means tensionedbetween posts at the opposite sides of the surgical table. Theelasticity of the restraint does not always insure immobility, and thissystem complicates draping the patients leg for surgery. When release isdesired, undraping is usually required, violating the aseptic area.

It has therefore been among the principal objects of this invention toprovide a surgical restraining appliance for bent-knee surgery which issimply to construct and adapt to a surgical table; which can be coveredby the surgical drapes without imposing limitations on the surgicalarea; and which can be released without undraping of the site ofsurgery.

DESCRIPTION OF THE DRAWINGS FIG. I is a side view depicting the surgicalappliance of this invention as it may appear in use;

FIG. 2 is an enlarged vertical face view of the surgical applianceshowing it in association with a portion of a surgical table;

FIG. 3 is an enlarged vertical section taken on line 3-3 of FIG. 2; and

FIG. 4 is a vertical sectional detailed view taken on line 4-4 of FIG.2.

DESCRIPTION OF A PREFERRED EMBODIMENT This appliance is used inassociation with the surgical table which is usually supplied with aside rail 12 on which may be attached clamps 14 the details of which arebest seen in FIG. 2. Clamps 14 comprises a U- shaped member thatstraddles rail I2 and includes the clampscrew 16. Base plate 18 has adownturned leg 20 which passes through slot 22 of clamp 14 intojuxtaposition to side rail 12 to which it is secured by a tightenableclamp screw 16.

Base bar 24 is attached in superposed relation to base plate 18 by meansof screw 26. Member 24 in this preferred embodiment supports upstandingjournals 28 and 30 in which, by means of trunnions 32 and 34, the archmember 36 is pivotally associated with base member 24.

Referring to FIG. 4, base block 44 is outstanding from the rear of theconcavo-convex saddle 42. It has a socket 46 therein. Block 44 has capblock 48 secured thereto by screws 50,50 and the assembly comprisesclamping means about the journal portion 40 of arch member 36. In thesocket 40 is a Teflon friction-block 52 pressed by spring 54 againstportion 40 to function as a braking means to hold saddle 42 in anadjusted angular relationship with respect to arch member 36.

Securement means between the base member 24 and one of the legs 38 ofthe arch member 36 is provided for maintaining the arch 36 in a selectedangular relationship relative the upper surface of table I0. This isaccomplished by providing the lower part of leg 38 and trunnion 34 witha toothed or notched segment 56 as shown in FIG. 3. Member 56 is securedto and rotates with trunnion 34 as the arch 36 is swung to one or theother of the angular positions. Member 56 has a plurality of notches 58on its periphery, one of which, in a selected position, is engaged bylatch tongue 60 on the end of lever or latch arm 62 that, by means ofpivot 64, is pivotally mounted in the upwardly open U-shaped member 66.The tongue end 60 of lever 62 is guidedly moved in a slot 66 in theupstanding arm 68. Pivot pin 64 is journalled in the other upstandingarm 70 of member 66. Hold-down spring 72 is anchored at its lower end tobase structure and at its upper end to lever 62 as best shown in FIG. 3.Lever 62 extends outward to provide a pad 72 whereby the latching levermay be depressed to raise its latch end 60 out of one of the notches 58.The appliance may be used on either the right or left hand side of thetable simply by rotating the saddle 42 I".

This appliance is particularly useful in surgery involving a person'sknee structure as suggested in FIG. 1 where circumstances require thatthe patient's leg be adjusted during surgery or maintained in theadjusted, usually bent, position and immobile. The patient reclines onthe table 10. The leg is raised and bent to a condition where the footrests on base structure 24. Arch member 36 is adjusted to an angularposition that will bring saddle 42 close to the shin of the patient tohold it against any movement which would tend to straighten out the leg.Normally a member of the surgical team makes this adjustment of theappliance and determines the positioning of the knee which is to beoperated on. The patients knee is draped in the customary manner.Usually the area of surgery is exposed through an opening in the drapingcloths.

Should it become necessary after draping has taken place to readjust thepatients leg or, as will occur during and at the other end of theoperation, to release the patients leg from the restraining influence ofthis appliance, the protruding outward end of lever 62 can easily bepressed upon through the drapes to raise the latch tongue 60 out of anotch 58 without necessarily breaching the sterile zone of surgery thathas been established in the immediate vicinity of the patients knee. Toreestablish the original restraint position on the leg or in the case ofselecting a new position during surgery the saddle 42 is grasped throughthe drapes and pulled up. The latch tongue 60 automatically engagesnotch 58.

It has been found that this appliance is particularly useful, also,during hand and arm surgery. In such event the device is mounted on theside rail of the surgical table 10 in a position more closely related tothe upper arm, elbow or forearm and hand of a patient. This may be byraising the leg 20 in clamp 14 so that the base structure is disposedover the patients body. Or its relation to the table top may bereversed, from that shown in FIG. 2, so that the arch 36 extendslaterally from the table at the side of the patient. The saddle 42 isthen adjusted to the substantially horizontal disposition to receivethat portion of the patients arm which is most practical to support.

In compliance with the statute. the invention has been described inlanguage more or less specific as to structural features. It is to beunderstood however, that the invention is not limited to the specificfeatures shown. since the means and construction herein disclosedcomprises a preferred form of putting the invention into effect. Theinvention is. therefore. claimed in any of its forms or modificationswithin the legitimate and valid scope of the appended claims,appropriately interpreted in accordance with the doctrine of equivalents.

What is claimed is:

l. A surgical appliance for use on a surgical table during leg surgery.comprising:

a base member including means for attachment to one side of a surgicaltable and shaped to extend inward of the table edge in overlyingrelation to said table;

an unobstructed arch member pivotally associated at the lower ends ofits legs with said base member and disposed laterally of said table edgeabove said base member at a location on said table to traverse the lowerportion of a patients limb and the patients foot to be placed thereinand resting on said base member;

securement means between said base member and one of the said legs ofsaid arch member for maintaining the latter in a selected angularrelationship (ill to the upper surface of said table and with respect toa selected angular disposition of a patients limb bent at the knee asfor surgery in the region of the knee; and

a saddle pivotally mounted on said arch member at its apex of a size andshape to bear on an appropriate surface area of the front lower portionof the patients limbv 2. An appliance according to claim 1 in which thesecurement means comprises a quick-release latchmechanism.

3. The appliance according to claim 2 in which the latch-mechanismincludes at least a pair of notches and a latch dog selectivelyengageable therein.

4. The appliance according to claim 2 in which the latch-mechanism isassociated with that leg of the arch member most readily accessible fromthe table edge from which the base member extends inward.

5. The appliance according to claim 1 in which the pivotal mount of thesaddle on the arch member in cludes frictional brake means operable tonormally maintain said saddle member in a selected angular dis positionrelative its axis of pivot.

6. The appliance according to claim 5 in which said frictional brakemeans includes a spring-pressed Teflon friction member to press on saidarch member at its apex.

1. A surgical appliance for use on a surgical table during leg surgery,cOmprising: a base member including means for attachment to one side ofa surgical table and shaped to extend inward of the table edge inoverlying relation to said table; an unobstructed arch member pivotallyassociated at the lower ends of its legs with said base member anddisposed laterally of said table edge above said base member at alocation on said table to traverse the lower portion of a patient''slimb and the patient''s foot to be placed therein and resting on saidbase member; securement means between said base member and one of thesaid legs of said arch member for maintaining the latter in a selectedangular relationship to the upper surface of said table and with respectto a selected angular disposition of a patient''s limb bent at the kneeas for surgery in the region of the knee; and a saddle pivotally mountedon said arch member at its apex of a size and shape to bear on anappropriate surface area of the front lower portion of the patient''slimb.
 2. An appliance according to claim 1 in which the securement meanscomprises a quick-release latch-mechanism.
 3. The appliance according toclaim 2 in which the latch-mechanism includes at least a pair of notchesand a latch dog selectively engageable therein.
 4. The applianceaccording to claim 2 in which the latch-mechanism is associated withthat leg of the arch member most readily accessible from the table edgefrom which the base member extends inward.
 5. The appliance according toclaim 1 in which the pivotal mount of the saddle on the arch memberincludes frictional brake means operable to normally maintain saidsaddle member in a selected angular disposition relative its axis ofpivot.
 6. The appliance according to claim 5 in which said frictionalbrake means includes a spring-pressed Teflon friction member to press onsaid arch member at its apex.